Dabigatran for Dental Procedures in Patients with High Risk Bleeding

Hossien Akbari; Mohsen Shahmoradi; Abbass Bagheri; Nazanin Roqani Dehkordi; Parisa Boostanifard; Parisa Moradimajd

doi:10.18502/aacc.v10i3.15698

Hossien Akbari Department of Prosthodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Mohsen Shahmoradi Department of Endodontics, School of Dentistry, Ahwaz Jundishapur University of Medical Sciences, Ahwaz, Iran.
Abbass Bagheri Department of Endodontics, School of Dentistry, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
Nazanin Roqani Dehkordi Department of Periodontology, School of Dentistry, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
Parisa Boostanifard Department of Pediatric Dentistry, school of Dentistry, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
Parisa Moradimajd Department of Anesthesiology, Allied Medical School, Iran University of Medical Sciences, Tehran, Iran.

DOI: https://doi.org/10.18502/aacc.v10i3.15698

Keywords: Dabigatran; Dental procedure; High-risk bleeding

Abstract

Background: Management of patients with high risk of bleeding during oral and dental procedures faces many challenges. The aim of this study was review strategies for facing high risk of bleeding patients taking dabigatran under dental procedure.

Methods: Articles and scientific texts will be searched in the six main databases, such as PubMed, Scopus, Web of Science, Science Direct, Google Scholar and Cochrane Library from 2007 to 2022, with keywords “dabigatran” AND “bleeding” AND “dental procedures” OR “dental care”. The inclusion criteria for articles included in the study were papers published about treatment patients with dabigatran and undergoing a dental procedure, English language and design of case reports, case series, quasi-experimental studies and clinical trials. This study was performed using PRISMA.

Results: At first, 43 references included and finally 8 articles that met the inclusion criteria were select. CASP and STORBE checklists used for quality evaluation. Two reviewers checked eligibility of the selected articles, separately. Challenging Controversial results were found in selected studies. 4 studies demonstrated that Dabigatran should be interrupted at least 12 hours before invasive dental procedures. Some studies highlight that discontinuing Dabigatran depends on the patient's renal function. Also, it showed that deciding whether to stop Dabigatran or not by cardiologists determine based on elective or emergency high-risk patients.

Conclusions: Based on the results of the included studies, it is better to decide to stop or continue dabigatran before any dental treatment based on the type of intervention, the risk of bleeding and the patient's clinical situation. However, is preferred to discontinue taking this drug in high risk of bleeding dental procedures.